Surgical cutting guide

ABSTRACT

Tools or other instruments can be used by a surgeon to complete an orthopedic procedure. One tool can include a resection tower and a valgus guide. The resection tower can include a cutting block and a dial coupled with the cutting block. The resection tower can be configured such that rotational movement of the dial, about an axis, effectuates movement of the cutting block along a plane substantially parallel with the axis. The dial, when rotated in a first direction, can move between a first position, which corresponds to a minimum cutting depth of the cutting block, and a second position, which corresponds to a maximum cutting depth of the cutting block. The valgus guide can be coupled with the resection tower and includes a rotatable member. The rotatable member can include an angular surface with one or more variable depth splines providing varus/valgus angle adjustment of the cutting block.

CLAIM OF PRIORITY

This application is a continuation of U.S. patent application Ser. No.13/720,251, filed on Dec. 19, 2012, which claims the benefit of U.S.Provisional Patent Application Ser. No. 61/577,466, filed on Dec. 19,2011, the benefit of priority of each of which is claimed hereby, andeach of which are incorporated by reference herein in its entirety.

BACKGROUND

Tools or other instruments can be used by a surgeon to complete anorthopedic procedure. For example, a surgical cutting guide can be usedduring an orthopedic procedure to prepare a bone for a prostheticimplant.

SUMMARY

The present disclosure is directed to surgical cutting guide systems andmethods for the placement of a cutting block on a bone during anorthopedic procedure. Using the surgical cutting guide systems andmethods, a surgeon can quickly and easily position the cutting block ata particular depth and at a particular varus/valgus angle during theorthopedic procedure.

The present inventors have recognized, among other things, that existingsystems and methods for adjusting a depth or a varus/valgus angle of acutting block fail to provide a surgeon with certain speed and ease ofuse features, such as fast return depth adjustment and minimal rotationto reach maximum varus/valgus angles. The present inventors have furtherrecognized that cutting block adjustment systems and methods can be mademore efficient by leveraging a previously positioned intramedullary rodor nail for placement purposes.

The present systems and methods provide or use a resection tower and avalgus guide. The resection tower can include a cutting block and a dialcoupled with the cutting block. The resection tower can be configuredsuch that rotational movement of the dial about an axis, effectuatesmovement of the cutting block along a plane substantially parallel withthe axis. The dial, when rotated in a first direction, can move betweena first position, which corresponds to a minimum cutting depth of thecutting block, and a second position, which corresponds to a maximumcutting depth of the cutting block. The dial, when rotated in the firstdirection past the second position, causes the cutting block to returndirectly to the minimum cutting depth.

The valgus guide can be coupled with the resection tower and includes arotatable member and a collet lock. The rotatable member can include anangular surface with one or more variable depth splines providingvarus/valgus angle adjustment of the cutting block. The variable depthsplines are configured such that rotation of the rotatable member lessthan 90 degrees can effectuate adjustment of the cutting block to amaximum varus/valgus angle. The collet lock is configured to couple thevalgus guide to an intramedullary rod or nail and thereby,advantageously provides a surgeon with an intramedullary securementmeans, instead of pinning, for accurate placement of the cutting block.An amount of time to secure the valgus guide to the intramedullary rodor nail via the collet lock can be less than an amount of time to pinthe valgus guide to a bone.

To better illustrate the surgical cutting guide systems and methodsdisclosed herein, a non-limiting list of examples is provided here:

In Example 1, a system comprises a resection tower including a cuttingblock, having a slot for guiding a cutting tool, and a dial, coupledwith the cutting block such that rotational movement of the dial aboutan axis effectuates movement of the cutting block along a planesubstantially parallel with the axis. The dial, when rotated in a firstdirection, is configured to move between a first position, correspondingto a minimum cutting depth of the slot, and a second position,corresponding to a maximum cutting depth of the slot. The dial, whenrotated in the first direction past the second position, is configuredto cause the slot to return directly to the minimum cutting depth.

In Example 2, the system of Example 1 is optionally configured such thatthe dial includes a first side, a second side, and an internal surfacedefining a bore extending about the axis between the first and secondsides. The internal surface includes a helical groove extending from afirst point, adjacent to the first side, to a second point, adjacent tothe second side.

In Example 3, the system of Example 2 is optionally configured such thatan axial distance between the first point and the second point along theinternal surface substantially corresponds to a distance between theminimum cutting depth of the slot and the maximum cutting depth of theslot.

In Example 4, the system of any one or any combination of Examples 2 or3 is optionally configured such that the helical groove extends lessthan 360 degrees around the internal surface.

In Example 5, the system of any one or any combination of Examples 2-4is optionally configured such that the internal surface includes asubstantially straight groove extending from the first point to thesecond point.

In Example 6, the system of any one or any combination of Examples 2-5is optionally configured such that the resection tower further includesa pin longitudinally disposed in a direction substantially parallel tothe axis. The pin includes a first end portion extending through thebore and a second end portion releasably coupled with the cutting block.

In Example 7, the system of Example 6 is optionally configured such thatthe pin includes a projection extending from the first end portion at anangle relative to the longitudinal disposition of the pin. Theprojection is configured to move along the helical groove from the firstpoint to the second point as the dial is rotated in the first directionfrom the first position to the second position, respectively.

In Example 8, the system of Example 7 is optionally configured such thatthe projection is configured to move along a substantially straightgroove extending from the first point to the second point as the dial isrotated in the first direction from the second position, respectively.

In Example 9, the system of any one or any combination of Examples 6-8is optionally configured such that the resection tower further includesa base, to which the dial and the pin are coupled, and a lockingmechanism configured to releasable couple the second end portion of thepin to the cutting block. The locking mechanism includes a lockinglever, a plunger, and a locking ball. The locking lever is movablebetween a locked position and an unlocked position and is coupled withthe first end portion of the pin. The plunger extends within the pin andincludes a locking ramped surface located near the second end portion ofthe pin. The locking ball is configured to be engageable with thelocking ramped surface and secures engagement between the pin and thecutting block when the locking lever is in the locked position.

In Example 10, the system of Example 9 optionally further includes aresilient member extending around the plunger from a first end to asecond end. The resilient member is configured to transition from acompressed state to an uncompressed state as the dial is rotated fromthe second position to the first position.

In Example 11, the system of any one or any combination of Examples 1-10optionally further includes a valgus guide, coupled with the resectiontower, including a rotatable member having an angular surface with oneor more variable depth splines.

In Example 12, the system of Example 11 is optionally configured suchthat the valgus guide further includes a valgus alignment guide and oneor more spherical contacts. The valgus alignment guide couples thevalgus guide with the resection tower and includes one or moredepressions. The one or more spherical contacts are positioned partiallywithin the one or more depressions and configured to engage with the oneor more variable depth splines.

In Example 13, the system of any one or any combination of Examples 11or 12 is optionally configured such that the rotatable member, whenrotated, effectuates adjustment of a varus/valgus angle of the cuttingblock. The valgus guide is configured such that a maximum varus/valgusangle is reached when the rotatable member is rotated less than 90degrees.

In Example 14, the system of Example 13 is optionally configured suchthat the rotatable member includes a plurality of angle reference markscorresponding to a plurality of varus/valgus angles. The plurality ofangle reference marks include at least a center reference mark,corresponding to a minimum varus/valgus angle, a right maximum referencemark, corresponding to a maximum right varus/valgus angle, and a leftmaximum reference mark, corresponding to a maximum left varus/valgusangle. In Example 15, the system of Example 14 is optionally configuredsuch that a space between each of the plurality of angle reference marksis identical.

In Example 16, the system of any one or any combination of Examples11-15 is optionally configured such that a thickness of the rotatablemember is greatest at a first point on the circumference of the angularsurface and is smallest at a second point, diametrically opposite thefirst point, on the circumference of the angular surface.

In Example 17, the system of Example 16 is optionally configured suchthat the angular surface comprises a first variable depth spline and asecond variable depth spline. The first and second variable depthsplines are positioned equidistant from a center line connecting thefirst and second points on the circumference of the angular surface.

In Example 18, the system of any one or any combination of Examples 16or 17 is optionally configured such that the one or more variable depthsplines taper in width from a first end, near the first point on thecircumference, to a second end, near the second point on thecircumference. The one or more variable depth splines can form an arcbetween the first and second ends.

In Example 19, the system of Example 18 is optionally configured suchthat the one or more variable depth splines have a first depth at thefirst end and have a second depth at the second end. The first depth isgreater than the second depth.

In Example 20, the system of any one or any combination of Examples11-19 is optionally configured such that the angular surface forms anangle relative to a plane perpendicular to an axis of the rotatablemember. The angle can correspond to a maximum right varus/valgus angleof the cutting block and to a maximum left varus/valgus angle of thecutting block.

In Example 21, the system of any one or any combination of Examples11-20 is optionally configured such that the valgus guide includes acollet lock configured to couple to an intramedullary rod or nail.

In Example 22, a method comprises sliding a system including a resectiontower, having a cutting block and a dial, and a valgus guide, having arotatable member, over an intramedullary rod or nail; turning therotatable member to adjust a varus/valgus angle of the cutting block,including engaging one or more spherical contacts with one or morevariable depth splines on an angular surface of the rotatable member;and turning the dial to adjust a cutting depth of the cutting block.

In Example 23, the method of Example 22 is optionally configured suchthat turning the dial includes turning the dial in a first directionfrom a first position, corresponding to a minimum cutting depth of thecutting block, to a second position, corresponding to a maximum cuttingdepth of the cutting block.

In Example 24, the method of any one or any combination of Examples 22or 23 is optionally configured such that turning the dial in the firstdirection further includes turning the dial past the second position,thereby directly returning the cutting block to the minimum cuttingdepth of the cutting block.

In Example 25, the method of any one or any combination of Examples22-24 is optionally configured such that turning the rotatable memberincludes turning the rotatable member less than 90 degrees andpositioning the cutting block at a maximum varus/valgus angle.

In Example 26, the surgical cutting guide system or method of any one orany combination of Examples 1-25 is optionally configured such that allelements or options recited are available to use or select from.

These and other examples and features of the present surgical cuttingguide systems and methods will be set forth in part in the followingDetail Description. This Summary is intended to provide an overview ofthe present subject matter—it is not intended to provide an exclusive orexhaustive explanation. The Detailed Description is included to providefurther information about the present surgical cutting guide systems andmethods.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, which are not necessarily drawn to scale, like numeralscan be used to describe similar components in different views. Thedrawings illustrate generally, by way of example, but not by way oflimitation, various embodiments discussed in the present patentdocument.

FIG. 1 illustrates a perspective view of a system including a resectiontower and a valgus guide, in accordance with at least one example of thepresent disclosure.

FIG. 2 illustrates an exploded view of a portion of the resection towerof FIG. 1, in accordance with at least one example of the presentdisclosure.

FIG. 3 illustrates a front view of a dial of a resection tower, inaccordance with at least one example of the present disclosure.

FIG. 4 illustrates a partial cross-sectional view of the dial of FIG. 3,such as along line 4-4.

FIG. 5 illustrates a side view of a portion of the resection tower ofFIG. 2, in accordance with at least one example of the presentdisclosure.

FIG. 6 illustrates a cross-sectional view of the portion of theresection tower of FIG. 5, such as along line 6-6.

FIG. 7 illustrates a top view of the portion of the resection tower ofFIG. 5, in accordance with at least one example of the presentdisclosure.

FIG. 8 illustrates an exploded view of the valgus guide of FIG. 1, inaccordance with at least one example of the present disclosure.

FIG. 9 illustrates a perspective view of a portion of the valgus guideof FIG. 8, in accordance with at least one example of the presentdisclosure.

FIG. 10 illustrates a perspective view of a rotatable member of a valgusguide, in accordance with at least one example of the presentdisclosure.

FIG. 11 illustrates an angular surface view of a rotatable member of avalgus guide, in accordance with at least one example of the presentdisclosure.

FIGS. 12A-I illustrate cross-sectional views of the rotatable member ofFIG. 11, along lines A-A to I-I.

FIG. 13 illustrates a top view of a valgus guide, in accordance with atleast one example of the present disclosure.

FIGS. 14A-C illustrate perspective views of a valgus guide, inaccordance with at least one example of the present disclosure.

FIG. 15 illustrates a method of using a system including a resectiontower and a valgus guide, in accordance with at least one example of thepresent disclosure.

DETAILED DESCRIPTION

FIG. 1 illustrates a perspective view of a system 10 including aresection tower 12 and a valgus guide 14, in accordance with at leastone example of the present disclosure. The system 10, according to thepresent disclosure, can be used to position a cutting block 2 at aparticular depth and at a particular varus/valgus angle on a bone duringan orthopedic procedure. For example, the system 10 can be used toprepare a distal end of a femur or a proximal end of a tibia for a kneearthroplasty procedure, a proximal end of a femur for a hip arthroplastyprocedure, or a proximal end of a humerus for a shoulder arthroplastyprocedure.

The resection tower 12 can include a cutting block 2 having a slot 4 toguide one or more cuts to be made by a cutting instrument, such as asaw, to remove a portion of a bone. The resection tower 12 can include adial 6 operatively coupled with the cutting block 2. Rotational movementof the dial 6, in a first direction, can effectuate movement of thecutting block 2 and adjust a depth of the slot 4 with respect to thebone. The dial 6 can include a plurality of rotatable positionscorresponding to a plurality of cutting depths of the slot 4. Forexample, a first position of the dial 6 can correspond to a minimumcutting depth of the slot 4, and a second position of the dial 6 cancorrespond to a maximum cutting depth of the slot 4. As the dial 6 isrotated, in the first direction, past the second position, the slot 4can return directly to the minimum cutting depth. Returning directly tothe minimum cutting depth can provide a surgeon with fast return depthadjustment capabilities, which can reduce the amount of time spentadjusting the depth of the cutting block 2, relative to the bone, duringan orthopedic procedure. The resection tower 12 can further include oneor more longitudinal posts 11 configured to couple the resection tower12 with the valgus guide 14.

The valgus guide 14 can adjust the varus/valgus angle of the cuttingblock 2. The valgus guide 14 can include a valgus alignment guide 16, arotatable member 18, and a collet lock 20. The valgus alignment guide 16can have one or more lumens to receive the one or more longitudinalposts 11 of the resection tower 12, thereby allowing the resection tower12 to couple to the valgus guide 14. The rotatable member 18 can includean angular surface with one or more variable depth splines, such asthose illustrated as reference numerals 182, 184 in FIGS. 11 and 12,below. The splines can enable a maximum varus/valgus angle to be reachedby rotating the rotatable member 18 less than 90 degrees. In an example,the maximum varus/valgus angle can be reached by rotating the rotatablemember 18 between 50 and 60 degrees, such as about 56 degrees. Thecollet lock 20 can couple the valgus guide 14 to a previously positionedintramedullary rod or nail (not shown) to secure the valgus guide 14 toa bone and provide for accurate placement of the cutting block 2. Thecollet lock 20 can increase operating room efficiency by enabling thevalgus guide 14 to be secured to the intramedullary rod or nail, insteadof pinning the valgus guide 14, to a distal end of a femur, for example.

FIG. 2 illustrates an exploded view of a portion of the resection tower12 of FIG. 1, in accordance with at least one example of the presentdisclosure. The portion of the resection tower 12 illustrated in FIG. 2excludes the cutting block 2 (which is illustrated in FIG. 1). Asillustrated in FIG. 2, the resection tower 12 can include the dial 6, apin 54, a base 32, a plunger 90, and a resilient member 84. The dial 6can include a first side 22, a second side 26, and an internal surface24 defining a bore 100 extending along an axis 25 between the first side22 and the second side 26. The internal surface 24 can include a helicalgroove extending from a first point, adjacent to the first side 22, to asecond point, adjacent to the second side 26. Additionally, the dial 6can include a substantially straight groove extending from the firstpoint to the second point.

The pin 54 can be longitudinally disposed in a direction substantiallyparallel to the axis 25. The pin 54 can include a first end portion 60and a second end portion 58, the latter of which is releasable coupledwith the cutting block 2. The pin 54 can include a projection 62extending from the first end portion 60 at an angle relative to thelongitudinal disposition of the pin 54. The projection 62 can beconfigured to move along the helical groove as the dial 6 is rotatedfrom a first position associated with the first point, which correspondsto the minimum cutting depth of the slot 4, to a second positionassociated with the second point, which corresponds to the maximumcutting depth of the slot 4. The projection 62 can also be configured tomove along the substantially straight groove as the dial 6 is rotated,in the first direction, past the second positioned to return the slot 4directly to the minimum cutting depth.

The base 32 can include one or more longitudinal posts 11, a firstholding block 36, and a second holding block 38. The one or morelongitudinal posts 11 can couple the resection tower 12 to the valgusguide 14. The first holding block 36 and the second holding block 38 canbe separated by a space 34. The space 34 can be configured to receive aportion of the dial 6 such that the dial 6 can rotate about the axis 25within the space 34. The first holding block 36 and the second holdingblock 38 can each include an opening 50 extending from a first surface42, 46 of the first and second holding blocks 36, 38, to a secondsurface 44, 48 of the first and second holding blocks 36, 38. Whenassembled, the first portion 60 of the pin 54 can extend through theopening 50 in the second holding block 38, the bore 100 of the dial 6,and the opening 50 in the first holding block 36. The second portion 60of the pin 54 can be movable along the axis 25 with respect to the dial6 and the base 32 to adjust the cutting depth of the slot 4.

The dial 6 can be coupled to the base 32 via locking pegs 30. The dial 6can include a plurality of positions corresponding to a plurality ofcutting depths of the slot 4. The locking pegs 30 are configured suchthat each position of the plurality of positions aligns at least one ofthe locking pegs 30 with one of the openings 31 in the first holdingblock 36 to maintain the dial 6 at a particular position. For example,when the at least one locking peg 30 is aligned with one of the openings31, the at least one locking peg 30 can partially extend into theopening 31.

The plunger 90 can be part of a locking mechanism configured toreleasable couple the second end portion 58 of the pin 54 to the cuttingblock 2. The locking mechanism can also include a locking lever 8 and alocking ball 66. The plunger 90 can include a ramped surface 96 and canextend within a bore 54 of the pin 54. The ramped surface 96 can bepositioned, when assembled, near the second end portion 58 of the pin 54such that the ramped surface 96 can engage with the locking ball 66. Thelocking ball 66 can secure the engagement between the pin 54 and thecutting block 2 when the locking lever 8 is in a locked position. Theramped surface 96 can interact with the locking ball 66 as the lockinglever 8 is transitioned from an unlocked position to the lockedpositioned to couple the cutting block 2 to the pin 54. For example,when the locking lever 8 is in the locked position, the ramped surface96 and the locking ball 66 interact such that the locking ball 66partially extends through a locking hole 57 positioned toward a secondend 76 of the pin 54. While in the locked position, the locking ball 66can partially extend into a corresponding hole in the cutting block 2 tocouple the cutting block 2 to the pin 54.

The pin 54 can be coupled to the locking lever 8 via openings 78positioned towards a first end 74 of the pin 54. The openings 78 canreceive a locking rod 98 that extends through the locking lever 8. Asthe locking lever 8 moves between the locked positioned and the unlockedposition, the relationship between the ramped surface 96 and the lockingball 66 changes such that the locking 66 ball is substantiallypositioned within a bore 56 of the pin 54 and uncouples the cuttingblock 2 from the pin 54.

The pin 54 and the plunger 90 can be coupled to the base 32. Forexample, the pin 54 can include first and second slots 64 extendingalong the first portion 60 of the pin 54. The first and second slots 64are positioned directly across from each other and extend in a directionparallel to the axis 25. Additionally, the plunger 90 can include a slot92 that extends in a direction parallel to the axis 25. A base rod 80can extend through the first and second slots 64 of the pin 54, the slot92 of the plunger 90, and wall openings 82 in the second holding block38 to moveably couple the pin 54 and the plunger 90 to the base 32. Whenthe pin 54 and the plunger 90 are coupled to the cutting block 2, thepin 54, the plunger 90, and the cutting block 2 can move along axis 25as an integral unit, with respect to the base 32, to adjust the cuttingdepth of the slot 4.

The resilient member 84 includes a first end 86 and a second end 88.When assembled, the resilient member 84 can be positioned around theplunger 90 and within the first portion 60 of the pin 54 (as illustratedin FIG. 6). The first end 86 of the resilient member 84 can bepositioned between a foot portion 94 of the plunger and the base rod 80.The resilient member 84 can be configured to be in an uncompressed statewhen the dial 6 is at the first position, corresponding to the minimumcutting depth of the slot 4, and can be configured to be in a compressedstate when the dial 6 is at the second position, corresponding to themaximum cutting depth of the slot 4. For example, as the dial 6 isrotated, in the first direction, from the first position to the secondposition, the projection 62 can move within the helical groove of thedial 6 and compress the resilient member 84 between the foot portion 94and the base rod 80. As the dial 6 is further rotated, in the firstdirection, past the second position, the projection 62 can becomealigned with the substantially straight groove of the dial and theresilient member 84 can transition from the compressed state to theuncompressed state. As the resilient member 84 transitions from thecompressed state to the uncompressed state, the projection 62 can movealong the substantially straight groove and return the slot 4 directlyto the first position, which corresponds to the minimum cutting depth ofthe slot 4.

FIG. 3 illustrates a front view of a dial 6, in accordance with at leastone example of the present disclosure. An external surface 40 of thedial 6 can define a plurality of knobs 106A-106E (hereinaftergenerically referred to “knob 106” or collectively as “knobs 106”). Eachknob 106 can represent a position of the dial 6, which in turn canrepresent a cutting depth of the slot 4. In the example of FIG. 3, thedial 6 includes five knobs 106; however, the dial 6 may include more orless than five knobs 106. The knob 106A can represent a minimum cuttingdepth that, when positioned at an upper-most dial location, correspondsto the minimum cutting depth of the slot 4. The knob 106E can representa maximum cutting depth that, when positioned at the upper-most diallocation, corresponds to the maximum cutting depth of the slot 4. Thecutting depth of the slot 4 corresponding to each knob 106, whenpositioned at the upper-most dial location, can increase from knob 106Ato knob 106E.

As further illustrated in FIG. 3, the internal surface 26 of the dial 6can include the helical groove 102 and the substantially straight groove104. As the dial 6 is rotated in the first direction 108 from the firstposition, associated with the knob 106A positioned at the upper-mostdial location, to the second position, associated with the knob 106Epositioned at the upper-most dial location, the cutting block 2 movesfrom the minimum cutting depth to the maximum cutting depth. Thesubstantially straight groove 104 is positioned between helical groovepositions associated with the knobs 106A and 106E, such that when thedial 6 is rotated past the second position, in the first direction 108,the cutting block 2 can return directly to the minimum cutting depth.

FIG. 4 illustrates a partial cross-sectional view of the dial 6 of FIG.3, such as along line 4-4. The internal surface 26 of the dial includesthe helical groove 102. The helical groove can be in the form of adepression (e.g., an internal thread), as shown in FIG. 6, or thehelical groove can be in the form of a projection (e.g., an externalthread), as shown in FIG. 4. In either form, the helical groove 102 canbe configured to engage the projection 62 of the pin 54.

In the example of FIG. 4, the helical groove 102 is an external threadthat can interact with the projection 62 of the pin 54. The helicalgroove 102 can extend from a first point 110, adjacent to the first side22 of the dial 6, to a second point 112, adjacent to the second side 26of the dial 6. An axial distance 114 between the first point 110 and thesecond point 112 can substantially correspond to a distance between theminimum cutting depth and the maximum cutting depth of the slot 4. Thehelical groove 102 can extend less than 360 degrees around the internalsurface 26. The substantially straight groove 104 can extend from thefirst point 110 to the second point 112 and is positioned between thefirst and second positions of the dial 6. That is, the substantiallystraight groove 104 is positioned between knob 106A, representing theminimum cutting depth of the slot 4, and knob 106E, representing themaximum cutting depth of the slot 4.

As the dial 6 is rotated in the first direction 108, from the firstposition to the second position, the projection 62 can move along thehelical groove 102 from the first position 110 to the second position112. As the projection 62 moves along the helical groove 102, thecutting depth of the slot 4 can be adjusted from the minimum cuttingdepth to the maximum cutting depth. As the dial 6 is rotated in thefirst direction 106, past the second position, the projection 62 canmove along the substantially straight groove 104 from the secondposition 112 to the first position 110. As the projection 62 moves alongthe substantially straight groove 104, the cutting depth of the slot 4can be adjusted from the maximum cutting depth directly to the minimumcutting depth. The resilient member 84, while the dial 6 is at thesecond position, can be configured to be in a compressed state such thatwhen the projection 62 aligns with the substantially straight groove104, the resilient member 84 transitions from the compressed state tothe uncompressed state returning the slot 4 directly to the minimumcutting depth associated with the first position of the dial 6.

FIG. 5 illustrates a side view of the portion of the resection tower 12of FIG. 2, in accordance with at least one example of the presentdisclosure. In FIG. 5, the dial 6 is shown in the first position (e.g.,the knob 106A is positioned at an upper-most dial location),corresponding to the minimum cutting depth of the slot 2. The pin 54 caninclude a plate portion 68 that is positioned between the first portion60 and the second portion 58 of the pin 54. The plate portion 68 caninclude a first surface 70 and a second surface 72. The first surface 70is configured to face the second surface 44 of the second holding block38. As the dial 6 is rotated in the first direction, from the firstposition to the second position, a distance 45 between the first surface70 of the plate 68 and the second surface 48 of the second holding block28 can increase. As the dial 6 is rotated in the first direction, pastthe second position to the first position, the distance 45 between thefirst surface 70 of the plate 68 and the second surface 48 of the secondholding block 38 can decrease.

FIG. 6 illustrates a cross-sectional view of the portion of theresection tower 12 of FIG. 5, such as along line 6-6. The locking lever8 is shown in a locked position and the locking ball 66 extends throughthe locking hole 57 of the pin 54. The ramped surface 96 can interactwith the locking ball 66 and when the locking lever 8 is in the lockedposition, the locking ball 66 can move along the ramped surface 96 andextend through the locking hole 57. When the locking lever 8 istransitioned to an unlocked positioned, such as by rotating the lockinglever 8 about locking rod 98, the plunger 90 can move with respect tothe pin 54 and the locking ball 66 can move along the ramped surface 97and be positioned substantially within the bore 56 of the pin 54. In theunlocked position, the locking ball 66 does not engage the correspondinghole in the cutting block 2 and the pin 54 and the cutting block 2 canbe separated.

In the example of FIG. 6, the projection 62 is positioned within ahelical groove 102, in the form of an internal thread, and the resilientmember 84 is positioned between the base rod 80 and the foot portion 93of the plunger 90. As shown, the projection 62 extends from a bottomsurface of the pin 54. However, the projection 62 can also extend fromthe top surface of the pin 54.

As the dial 6 is rotated in the first direction from the first positionto the second position, the projection 62 can move along the helicalgroove 120 causing the pin 54 and plunger 90 to move linearly withrespect to the base 32 and the dial 6. When the pin 54 and the plunger90 are coupled to the cutting block 2, the pin 54, the plunger 90, andthe cutting block 2 can move along axis 25 as an integral unit withrespect to the base 32 to adjust the cutting depth of the slot 4.

The resilient member 84 can be configured to be in an uncompressed statewhen the dial 6 is at the first position, corresponding to the minimumcutting depth of the slot 4, as illustrated in FIG. 6. As the dial 6 isrotated in the first direction from the first position to the secondpositioned, the projection 62 can move within the helical groove 102 cancause the resilient member to transition to a compressed state. Forexample, the resilient member 84 is positioned between the base rod 80and the foot portion 94 of the plunger 90. As the pin 54 and plunger 90move along axis 25 with respect to base rod 80, the resilient memberbecomes compressed as a distance between the base rod 80 and the footportion 94 decreases.

When the dial 6 is rotated in the first direction past the secondposition, the projection 62 can become aligned with the substantiallystraight groove (shown as reference number 104 in FIGS. 3 and 4) and theresilient member 84 can transition from the compressed state to theuncompressed state. As the resilient member 84 transitions from thecompressed state to the uncompressed state, the projection 62 movesalong the substantially straight groove and the slot 4 can returndirectly to the minimum cutting depth, which corresponds to the firstposition of the dial 6.

FIG. 7 illustrates a top view of the portion of the resection tower 12of FIG. 5, in accordance with at least one example of the presentdisclosure. As shown, the dial 6 is in the first position correspondingto the minimum cutting depth of the slot 2. The knobs 106 can includemarkings to indicate a cutting depth associated with each knob 106, whenpositioned at an upper-most dial location. By way of example, knob 106Acan include a “0” marking indicating that the cutting block 2 is at theminimum cutting depth (e.g., zero millimeters) and knob 106E can includea “4” marking indicating that the cutting block 2 is at the maximumcutting depth (e.g., 4 millimeters). The substantially straight groovecan be positioned between knob 106A and 106E enabling the slot 4 toreturn to the minimum cutting depth when the dial 6 is rotated in thefirst direction past the second position. In this example, the secondposition is associated with knob 106E positioned at the upper-most diallocation. In an example, the dial 6 can include an opening 120 that isin communication with the substantially straight groove.

The pin 54 can also include a depth gauge 118 that aligns with referencemarkings 116 on the second holding block 38 to indicate a cutting depthof the slot 4. When the dial 6 is at the first position, correspondingto the minimum cutting depth of the slot 4, the depth gauge 118 can bealigned with the “0” reference marking 116 indicating that the cuttingdepth of the slot 4 is at the minimum cut depth. When the dial 6 is atthe second position, corresponding to the maximum cutting depth of theslot 4, (e.g., four millimeters), the depth gauge 118 can be alignedwith the “+4” reference marking 116.

FIG. 8 illustrates an exploded view of the valgus guide 14 of FIG. 1, inaccordance with at least one example of the present disclosure. Thevalgus guide 14 can include a valgus alignment guide 16 and a rotatablemember 18. The valgus alignment guide 16 can include one or more slots124 configured to receive the one or more longitudinal posts 11 of theresection tower 12 (as illustrated in FIG. 1) to couple the valgus guide16 to the resection tower 12. The valgus alignment guide 16 can includea first surface 128 and a second surface 129, which is opposite thefirst surface 128. The first surface 128 can be a bone contactingsurface and the second surface 129 can include one or more depressions130. The valgus alignment guide 16 can further include one or morespherical contacts 160 positioned partially within the one or moredepressions 130. The valgus guide 16 can further include an alignmentport 126 that is configured to receive at least an intramedullary rod ornail and rotate about a rotation axis 193 to adjust the varus/valgusangle of the cutting block 2.

The rotatable member 18 can include an angular surface 136 with one ormore variable depth splines (illustrated in FIG. 11 as reference numbers182 and 184). The rotatable member 18 can include a bore 140 that isconfigured to receive the intramedullary rod or nail. The intramedullaryrod or nail can be configured to extend through the bore 140 and thealignment port 124. The one or more spherical contacts 160 can engagewith the one or more variable depth splines such that, when rotated, therotatable member 18 can effectuate adjustment of a varus/valgus angle ofthe cutting block 2 by rotating the valgus alignment guide 16 about therotation axis 192.

The valgus guide 14 can further include a reference member 151 having areference base 152, a rotation post 148, and a locking post 156. Therotation post 148 can extend from a first side 153 of the reference base152 and the locking post 156 can extend from a second side 157 of thereference base 152. The reference member 151 can be coupled to thevalgus alignment guide 16 and the rotatable member 18. For example, therotation post 148 can extend through the bore 140 of the rotatablemember 18 and into the adjustment port 126 of the valgus alignment guide16. The valgus alignment guide 16 can include rotation holes 193 thatcan be aligned with openings 150 that extend through the rotation post148. When assembled, the rotation holes 193 and the openings 150 can beconfigured to receive rotation pins 122 such that the valgus alignmentguide 16 can rotate about the rotation axis 155. The rotation axis 155can extend centrally through the rotation holes 193 and the openings 150and be substantially perpendicular with respect to a longitudinal axis149 of the valgus guide 14. The valgus guide 14 can also include alocking hole and a locking pin configured to secure the valgus guide toa distal end of a bone.

The rotatable member 18 can be coupled to the reference member 151. Forexample, the rotatable member 18 can be coupled to the reference member151 via a primary locking mechanism and a secondary locking mechanism.The primary locking mechanism can include a lock 132 and a resilientmember 134. The primary locking mechanism, when locked, can preventrotation of the rotatable member 18. The lock 132 can include aprojection 135 that is configured to extend into and engage a firstindentation positioned on the first side 153 of the reference body 152.In response to an applied force, the lock 132 can compress the resilientmember 134 and the projection 135 can disengage from the indentation.Once disengaged, the rotatable member 18 can rotate about thelongitudinal axis 149.

The secondary locking mechanism can assist in guiding the rotatablemember 18 to a particular varus/valgus angle. The first side 153 of thereference base 152 can include a plurality of second indentationsconfigured to be engaged with pins 144 of the rotatable member 18. Thepins 144 can couple to the rotatable member and include the compressiblemembers 146. When the rotatable member 18 is rotated while the primarylocking mechanism is in an unlocked state, the compressible members 146can compress into the pins 144 and enable the rotatable member 18 torotate. For each varus/valgus angle, the pins 144 can align with one ormore of the plurality of second indentations to assist in guiding therotatable member 18 to a particular varus/valgus angle. That is, thepins 144 can engage one or more second indentations when the rotatablemember 18 is rotated to each varus/valgus angle.

The rotatable member 18 can further include the collet lock 20. Thecollet lock 20 can include the locking post 158 and a turn knob 159. Thelocking post 156 can include a plurality of threads 158 configured toengage corresponding threads along an internal surface of the turn knob159. The locking post 156 can include a plurality of flexible pegs 160.A bore 142 extending through the reference member 151 can be configuredto receive the intramedullary rod or nail. As the turn knob 159 isturned in a first direction 161, the flexible pegs 160 can compress ontothe intramedullary rod or nail and couple the valgus guide 14 to theintramedullary rod or nail. When the turn knob 159 is turned in a seconddirection 162, the flexible pegs 160 can release the intramedullary rodor nail and uncouple the valgus guide 14 from the intramedullary rod ornail.

FIG. 9 illustrates a perspective view of a portion of the valgus guide14 of FIG. 8, in accordance with at least one example of the presentdisclosure. As shown in FIG. 9, the rotatable member 18 can be coupledto the reference member 151. A thickness 172 of the rotatable member 18can be greatest at a first point 166 on the circumference of the angularsurface 136. A thickness 173 of the rotatable member 18 can be smallestat a second point 168, diametrically opposite the first point 166, onthe circumference of the angular surface 136. The angled surface 136 canform an angle 170 relative to a plane 174 perpendicular to thelongitudinal axis 149 of the rotatable member. The angle 170 cancorrespond to a maximum left varus/valgus angle of the cutting block 2and a maximum right varus/valgus angle of the cutting block 2.

FIG. 10 shows an example of a rotatable member 18. The rotatable member18 can include a plurality of angle reference marks 138 corresponding toa plurality of varus/valgus angles. The plurality of angle referencemarks 138 can include a center reference mark 176 corresponding to aminimum varus/valgus angle, a right maximum reference mark 175corresponding to a maximum right varus/valgus angle, and a left maximumreference mark 178 corresponding to a maximum left varus/valgus angle. Aspace 180 between each of the plurality of angle reference marks 136 canbe identical. In an example, each reference mark of the plurality ofreference marks 136 can correspond to a same relative adjustment to thevarus/valgus angle. As shown in the example of FIG. 10, the rotatablemember can have a maximum right varus/valgus angle and a maximum leftvarus/valgus angle of nine degrees. In addition, by turning therotatable member 18 one reference mark 138, a user can adjust thevarus/valgus angle by, for example, one degree.

FIG. 11 illustrates a perspective view of a rotatable member, inaccordance with at least one example of the present disclosure. Theangled surface 136 of the rotatable member can include a first variabledepth spline 182 and a second variable depth spline 184. The first andsecond variable depth splines 182, 184 can be positioned equidistantfrom a center line 186 connecting the first and second points 166, 168on the circumference of the angular surface 136. The first and secondvariable depth splines 182, 184 can taper in width from a first end 188,near the first point 166 on the circumference, to a second end 190, nearthe second point 168 on the circumference, as shown in FIGS. 12A-12I.The first and second variable depth splines 182, 184 can form an arcbetween the first and second ends 188, 190. The first and secondvariable depth splines 182, 184 can have a first depth at the first end188 and can have a second depth at the second end 190, where the firstdepth is greater than the second depth, as incrementally shown in FIGS.12A-12I. The first and second variable depth splines 182, 184 enable thespacing 180 between the reference markings 136 (as illustrated in FIG.10) to be identical. Additionally, the variable depth splines 182, 184enable the maximum right varus/valgus angle and the maximum leftvarus/valgus angle to be reached by rotating the rotatable member 18less than 90 degrees. In an example, the maximum right and leftvarus/valgus angle can be reached by rotating the rotatable member 18plus or minus fifty-six degrees (+/−56°).

FIGS. 12A-12I illustrate cross-sectional views of the rotatable memberof FIG. 11, such as along lines A-A to I-I. As illustrated in FIGS.12A-12I, the depth and width of the first and second variable depthsplines 182, 184 can vary from the first end 188 to the second end 190.The depth and width can vary based on the maximum right and leftvarus/valgus angle and an amount of rotation of the rotatable member 18to reach the maximum right and left varus/valgus angle. In the exampleof FIGS. 12A-12I, the maximum right and left varus/valgus angle is plusor minus nine degrees (+/−9°) and the amount of rotation to reach themaximum right and left varus/valgus angle is approximately plus or minusfifty-six degrees (+/−56°). The width 192 of the first variable depthspline 182 and the width 194 of the second variable depth spline 184vary from the first end 188 to the second end 190 of the first andsecond variable depth splines 182, 184. The depth 196 of the firstvariable depth spline 182 and the depth 198 of the second variable depthspline 184 vary from the first end 188 to the second end 190. The widths192, 194 and the depths 196, 198 for the first and second variable depthsplines 182, 184, along lines A-A to I-I of FIG. 11, are provided by wayof example in Table 1.

TABLE 1 Width Depth (millimeters) (millimeters) First Second FirstSecond Variable Variable Variable Variable Line depth Spline DepthSpline depth Spline Depth Spline A-A 0.25 0.83 2.16 3.72 B-B 0.31 0.752.40 3.57 C-C 0.35 0.69 2.56 3.40 D-D 0.38 0.64 2.66 3.34 E-E 0.40 0.602.71 3.26 F-F 0.41 0.58 2.74 3.20 G-G 0.41 0.57 2.74 3.17 H-H 0.42 0.572.76 3.17 I-I 0.51 0.51 3.02 3.02

FIG. 13 illustrates a top view of a valgus guide 14, in accordance withat least one example of the present disclosure. The one or morespherical contacts 160 can engage with the one or more variable depthsplines such that, when rotated, the rotatable member 18 can effectuateadjustment of a varus/valgus angle of the cutting block 2. For example,the valgus alignment guide 16 can rotate about the rotation axis(aligned with rotation pin 122) in a direction of the movement arrows200 to adjust a varus/valgus angle of the cutting block 2. As shown inthe example of FIG. 13, the reference base 152 can include an anglegauge 154 that can indicate the varus/valgus angle of the cutting block2. The valgus guide 14 of the present disclosure can enable a maximumvarus/valgus angle of the cutting block 2 to be reached by rotating therotatable member 18 less than 90 degrees. Additionally, the collet lock20 can secure the valgus guide 14 to an intramedullary rod or nail foraccurate placement of the cutting block 2 instead of pinning the valgusalignment guide 16 to a distal end of a bone.

FIGS. 14A-C illustrate perspective views of a valgus guide 202, inaccordance with at least one example of the present disclosure. Thevalgus guide 202 can be coupled with the resection tower 12. Forexample, the valgus guide 202 can include one or more slots 208 that canbe configured to receive one or more longitudinal posts 11 of theresection tower 12. The valgus guide 202 can include a bore 220 (asillustrated in FIG. 14C) that can be configured to receive anintramedullary rod or nail. Depending on the orientation of the valgusguide 202 with respect to a bone, the valgus guide 202 can position thecutting block 2 at either a fixed right varus/valgus angle or a fixedleft varus/valgus angle. As illustrated in FIGS. 14A and B, a bonecontacting surface 204 can form an angle 224 with respect to a plane 214that is perpendicular to a longitudinal axis 212 of the valgus guide202. The angle 224 can correspond to the fixed right and leftvarus/valgus angle.

As illustrated in FIG. 14A, the valgus guide 202 can include a marking“5° R” indicating that the fixed varus/valgus angle is a five degreeright varus/valgus angle. As illustrated in FIG. 14B, the valgus guide202 can include a marking “5° L” indicating that the fixed varus/valgusangle is a five degree left varus/valgus angle. The valgus guide 202 caninclude a locking hole 222 and a locking pin 216 configured to securethe valgus guide 202 to a distal end of a bone.

FIG. 15 illustrates a method 300 of using a system including a resectiontower and a valgus guide, in accordance with at least one example of thepresent disclosure. At 302, the method 300 can include sliding a systemover an intramedullary rod or nail. The system can include a resectiontower, having a cutting block and a dial, and a valgus guide, having arotatable member, over an intramedullary rod or nail.

At 304, the method can include turning the rotatable member to adjust avarus/valgus angle of the cutting block. Turning the rotatable membercan include engaging one or more spherical contacts with one or morevariable depth splines on an angular surface of the rotatable member. Inan example, turning the rotatable member less than 90 degrees caninclude positioning the cutting block at a maximum varus/valgus angle.

At 306, the method can include turning the dial to adjust a cuttingdepth of the cutting block. The dial can be turned in a first directionfrom a first position, corresponding to a minimum cutting depth of thecutting block, to a second position, corresponding to a maximum cuttingdepth of the cutting block. The dial, when turned in the first directionpast the second position, can directly return the cutting block to theminimum cutting depth.

The above Detailed Description includes references to the accompanyingdrawings, which form a part of the Detailed Description. The drawingsshow, by way of illustration, specific embodiments in which the presentsurgical cutting guide systems and methods can be practiced. Theseembodiments are also referred to herein as “examples.”

The above Detailed Description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or moreelements thereof) can be used in combination with each other. Otherembodiments can be used, such as by one of ordinary skill in the artupon reviewing the above description. Also, various features or elementscan be grouped together to streamline the disclosure. This should not beinterpreted as intending that an unclaimed disclosed feature isessential to any claim. Rather, inventive subject matter can lie in lessthan all features of a particular disclosed embodiment. Thus, thefollowing claims are hereby incorporated into the Detailed Description,with each claim standing on its own as a separate embodiment. The scopeof the invention should be determined with reference to the appendedclaims, along with the full scope of equivalents to which such claimsare entitled.

In the event of inconsistent usages between this document and anydocument so incorporated by reference, the usage in this documentcontrols.

In this document, the terms “a” or “an” are used to include one or morethan one, independent of any other instances or usages of “at least one”or “one or more.” In this document, the term “or” is used to refer to anonexclusive or, such that “A or B” includes “A but not B,” “B but notA,” and “A and B,” unless otherwise indicated. In this document, thephrase “varus/valgus angle” is used to refer to a varus angle only, avalgus angle only, or both a varus angle and a valgus angle.

In the appended claims, the terms “including” and “in which” are used asthe plain-English equivalents of the respective terms “comprising” and“wherein.” The terms “including” and “comprising” are open-ended, thatis, a system or method that includes elements in addition to thoselisted after such a term in a claim are still deemed to fall within thescope of that claim. Moreover, in the following claims, the terms“first,” “second,” and “third,” etc. are used merely as labels, and arenot intended to impose numerical requirements on their objects.

The Abstract is provided to allow the reader to quickly ascertain thenature of the technical disclosure. It is submitted with theunderstanding that it will not be used to interpret or limit the scopeor meaning of the claims.

What is claimed is:
 1. A system, comprising: a resection tower includinga cutting block, having a slot for guiding a cutting tool; and a valgusguide; configured to be coupled with the resection tower, the valgusguide including: a rotatable member having an angular surface with oneor more variable depth splines formed on the angular surface, theangular surface forming an acute angle relative to a plane perpendicularto a longitudinal axis of the rotatable member; a valgus alignmentguide, through which the valgus guide is coupled with the resectiontower, having one or more depressions; and one or more sphericalcontacts positioned partially within the one or more depressions andengaged with the one or more variable depth splines, wherein therotatable: member, when rotated, is configured to effectuate adjustmentof a varus/valgus angle of the cutting block, and wherein a maximumvarus/valgus angle is reached when the rotatable member is rotated lessthan 90 degrees.
 2. The system of claim 1, wherein the rotatable memberincludes a plurality of angle reference marks corresponding to aplurality of varus/valgus angles; the plurality of angle reference marksinclude at least a center reference mark corresponding to a minimumvarus/valgus angle, a right maximum reference mark corresponding to amaximum right varus/valgus angle, and a left maximum reference markcorresponding to a maximum left varus/valgus angle.
 3. The system ofclaim 1, wherein a thickness of the rotatable member is greatest at afirst point on a circumference of the angular surface and is smallest ata second point, diametrically opposite the first point, on thecircumference of the angular surface.
 4. The system of claim 3, whereinthe angular surface comprises a first variable depth spline and a secondvariable depth spline, the first and second variable depth splinespositioned equidistant from a center line connecting the first andsecond points on the circumference of the angular surface.
 5. The systemof claim 4, wherein the first and second variable depth splines taper inwidth from a first end; near the first point on the circumference, to asecond end, near the second point on the circumference, and wherein thefirst and second variable depth splines form an arc between the firstand second ends.
 6. The system of claim 5, wherein the first and secondvariable depth splines have a first depth at the first end and have asecond depth at the second end, the first depth greater than the seconddepth.
 7. The system of claim 1, wherein the valgus guide includes acollet lock configured to couple to an intramedullary rod or nail.
 8. Asystem, comprising: a resection tower including a cutting block; havinga slot for guiding a cutting tool; and a valgus guide, configured to becoupled with the resection tower, the valgus guide including: arotatable member; one or more variable depth splines, wherein the one ormore variable depth splines taper in width from a first end to a secondend; and one or more spherical contacts configured to engage with theone or more variable depth splines, wherein the rotatable member, whenrotated; in configured to effectuate adjustment of a varus/valgus angleof the cutting block.
 9. The system of claim 8, wherein a maximumvarus/valgus angle is reached when the rotatable member is rotated lessthan 90 degrees.
 10. The system of claim 8, wherein the rotatable memberincludes an angular surface including the one or more variable depthsplines, wherein the angular surface forms an acute angle relative to aplane perpendicular to a longitudinal axis of the rotatable member. 11.The system of claim 10, wherein a thickness of the rotatable member isgreatest at a first point on a circumference of the angular surface andis smallest at a second point, diametrically opposite the first point,on the circumference of the angular surface.
 12. The system of claim 11,wherein the angular surface includes a first variable depth spline and asecond variable depth spline, and wherein the first and second variabledepth splines are positioned equidistant from a center line connectingthe first and second points on the circumference of the angular surface.13. The system of claim 11, wherein the one or more variable depthsplines taper in width from the first end, near the first point on thecircumference, to the second end, near the second point on thecircumference, and wherein the one or more variable depth splines forman arc between the first and second ends.
 14. The system of claim 13,wherein the one or more variably: depth splines have a first depth atthe first end and have a second depth at the second end, the first depthgreater than the second depth.
 15. The system of claim 8, furtherincluding a valgus align en guide, through which the valgus guide iscoupled with the resection tower.
 16. The system of claim 15, whereinthe valgus alignment guide includes a first surface and a second surfaceopposite the first surface, the first surface is a bone contactingsurface and the second surface including one or more depressions. 17.The system of claim 16, wherein the one or more spherical contacts areconfigured to be positioned partially within the one or more depressionswhile engaged with the one or more variable depth splines.
 18. A method,comprising: sliding a system including a resection tower, having acutting block and a dial, and a valgus guide, having a rotatable member,over an intramedullary rod or nail; and turning the rotatable member toadjust a varus/valgus angle of the cutting block, including engaging oneor more spherical contacts with one or more variable depth splines on anangular surface of the rotatable member, the angular surface forming anacute angle relative to a plane perpendicular to a longitudinal axis ofthe rotatable member.
 19. The method of claim 18, wherein turning therotatable member includes turning the rotatable member less than 90degrees and positioning the cutting block at a maximum varus/valgusangle.
 20. The method of claim 18, wherein the valgus guide includes: avalgus alignment guide, through which the valgus guide is coupled withthe resection tower, having one or more depressions, wherein the one ormore spherical contacts are positioned partially within the one or moredepressions and engaged with the one or more variable depth splines.